"Let's hear from the bedside nurse and [let that help] guide and direct our vision rather than going from the top down," Sheff says.
And the nurses feel increased job satisfaction because the hospital is investing in them.
"You're really upping the standards for nursing," Torosian says. "I think there's evidence out there that if your staff is happy, your patients are going to be happier and your care is going to be better."
For example, a separate study in the Journal of Nursing Administration found that "[MRP] hospital nurses were 18% less likely to be dissatisfied with their job (P < .05) and 13% less likely to report high burnout (P < .05). [MRP] hospitals have significantly better work environments than non-[MRP] hospitals." Burnout has long been linked to poorer patient care.
Of course, simply pointing to happier nurses doesn't really answer the questions raised in patient outcomes study. But Sheff counters that the outcomes measured in the study don't just depend on nursing.
"Those are outcomes in terms of things that nursing itself doesn't have total control over," she says. For example, there are a lot of factors that go into whether a patient develops postoperative sepsis; one recent study found that "the development of postoperative sepsis is multifactorial," and that "factors associated with the development of sepsis included race, age, hospital size, hospital location, and patient income."